Jonathan Abramowitz

Jonathan Stuart Abramowitz (born June 11, 1969) is an American clinical psychologist and Professor in the Department of Psychology and Neuroscience at the University of North Carolina at Chapel Hill (UNC-CH). He is an authority on obsessive-compulsive disorder (OCD) and anxiety disorders whose work is highly cited. He maintains a research lab and serves as the Director of the UNC-CH Anxiety and Stress Disorders Clinic. Abramowitz approaches the understanding and treatment of psychological problems from a cognitive-behavioral perspective.

Abramowitz earned his B.A. in Psychology from Muhlenberg College in 1991, his M.A. in Psychology from Bucknell University in 1993, and his Ph.D. in Clinical Psychology from the University of Memphis in 1998. He completed both a predoctoral internship and postdoctoral fellowship at the Center for Treatment and Study of Anxiety at the University of Pennsylvania. He was a staff psychologist and Associate Professor at the Mayo Clinic (Rochester, Minnesota) from 2000 until 2006. He moved to North Carolina in the summer of 2006.

Abramowitz's research focuses on the development and evaluation of cognitive-behavioral treatments (CBT) for OCD and other anxiety-related problems, as well as on understanding the nature and psychopathology of these problems. He is the author of approximately 300 publications, including more than 10 books and over 250 peer reviewed journal articles and book chapters. He has also worked extensively as a book and journal editor. Abramowitz has given invited lectures around the world and served in numerous editorial and advisory roles for scientific journals and organizations.

Abramowitz is board certified by the American Board of Behavioral Psychology and is a licensed psychologist in North Carolina. In his clinical practice, he specializes in providing outpatient consultation and cognitive-behavioral treatment of OCD and other anxiety-related problems.

Treatment of OCD and anxiety: A major focus of Abramowitz's research is the treatment of OCD. His work primarily addresses exposure and response prevention (ERP; a form of cognitive-behavioral therapy [CBT]) and he has conducted treatment outcome studies and meta-analytic reviews of this therapy. He has also investigated factors that predict good and poor outcomes.

Abramowitz has helped to develop an OCD treatment program combining ERP with Acceptance and Commitment Therapy (ACT). He has also helped to develop couple-based ERP programs for OCD and Body Dysmorphic Disorder.

Abramowitz has written about, and is conducting research to better understand, how to enhance the outcome of exposure therapy/ERP by optimizing extinction learning. This work is drawn from inhibitory learning models of exposure.

Nature and symptoms of OCD: Abramowitz's research also focuses on trying to understand the complex symptomatology of OCD. His work has identified 4 subtypes/dimensions of this disorder that involve somewhat distinct cognitive and behavioral phenomena: (a) contamination, (b) responsibility for harm/mistakes, (c) unacceptable thoughts, and (d) incompleteness/symmetry. He has also contributed to the re-conceptualization of hoarding as separate from OCD.

Abramowitz has argued that OCD symptoms lie on a continuum with normal everyday experiences, and that one’s learning history (and to a lesser extent, their biology) influence the frequency, intensity, and duration of OCD symptoms. He has also criticized the DSM-5’s re-classification of OCD as separate from the anxiety disorders and as overlapping with conditions such as Hair Pulling Disorder and Skin Picking Disorder. Abramowitz is generally critical of biomedical models which view problems such as OCD and anxiety as brain diseases or genetic disorders.

Assessment of OCD: Abramowitz led a team of researchers in 2010 that developed the Dimensional Obsessive-Compulsive Scale (DOCS), a 20-item self-report instrument designed to measure the severity of the four types of OCD symptoms (see above). The DOCS has been translated into multiple languages for use worldwide.

Cognitive-behavioral factors and models of OCD and anxiety: The cognitive-behavioral model is the leading conceptual approach to understanding OCD and anxiety disorders. Abramowitz conducts cross-sectional, experimental, and prospective (longitudinal) research that has helped to clarify and advance this conceptual model. His work focuses on cognitive biases such as anxiety sensitivity, thought-action fusion, intolerance of uncertainty, and attentional biases that factor in the persistence of OCD and irrational fear. With his team at UNC, he has developed experimental paradigms for studying thought-action fusion and intolerance of uncertainty. His work has also demonstrated that cognitive factors prospectively predict the escalation of intrusive thoughts into obsessions.

Abramowitz also conducts studies on cognitive-behavioral factors in other anxiety and related problems, including health/illness anxiety, shy bladder syndrome, panic disorder, and hoarding.

Scrupulosity: Abramowitz has conducted studies on, and developed a cognitive-behavioral model of, scrupulosity (religious obsessions and compulsions). He also developed the Penn Inventory of Scrupulosity (PIOS) to measure this phenomenon.

Prevention of postpartum OCD: Abramowitz developed and evaluated a prevention program for OCD symptoms in new parents. This work was derived from previous studies led by Abramowitz showing that certain types of cognitive/psychological phenomena (such as the tendency to catastrophically misinterpret unwanted thoughts) predict the development of OCD symptoms in the postpartum. The prevention program, known as "Baby PREP", can be delivered as part of perinatal education classes and was shown to be more effective than a credible placebo control program in preventing OCD symptoms among vulnerable expecting/new parents.

Cross-cultural factors: Abramowitz has conducted research on cultural, religious, and racial differences in the expression of anxiety and OCD symptoms and related phenomena. He is part of a multi-national collaborative effort studying the nature of intrusive obsessional thoughts in cultures and countries around the world.

Abramowitz's contributions to the fields of OCD, anxiety disorders, and clinical psychology are recognized by his colleagues, peers, and the media through numerous honors, awards, and appearances. He is a Fellow and Past President of the Association for Behavioral and Cognitive Therapies (ABCT) and serves on the International OCD Foundation Scientific and Clinical Advisory Board. He is the recipient of a Muhlenberg College Alumni Achievement Award, the David Shakow Early Career Award for Outstanding Contributions to the Science and Practice of Clinical Psychology (from Division 12 of the American Psychological Association), and the Mayo Clinic Department of Psychiatry and Psychology Outstanding Contributions to Research Award.

Abramowitz has served on the Editorial Boards of several scientific journals and as Associate Editor of Journal of Cognitive Psychotherapy (2008–present) and Associate Editor of Behaviour Research and Therapy (2006-2015). He is the Editor-in-Chief of the Journal of Obsessive-Compulsive and Related Disorders. His ResearchGate score is higher than 97.5% of this site's members.

Abramowitz was invited by colleagues in Norway to help train and supervise 30 OCD treatment teams in that country. The training is part of an initiative funded by the Norwegian government to ensure that all individuals with OCD in Norway have access to effective treatment.

Abramowitz has twice been appointed as Associate Chair of the University of North Carolina at Chapel Hill Department of Psychology and Neuroscience, a position he held from 2007-2017.

Abramowitz lives in Chapel Hill, North Carolina, with his wife and two daughters.

Books

• Abramowitz, J. S. (2006).Understanding and treating obsessive-compulsive disorder: A cognitive-behavioral approach. Mahwah, NJ: Lawrence Erlbaum Associates, Inc. ISBN 9780805851847
• Abramowitz, J. S., Taylor, S., & McKay, D. (Eds.) (2008).Clinical handbook of obsessive-compulsive disorder and related problems.Baltimore, MD: The Johns Hopkins University Press. ISBN 978-0801886973
• Abramowitz, J. S. (2012). The stress less workbook: Simple strategies to relieve pressure, manage commitments, and minimize conflicts. New York: Guilford Press. ISBN 978-1-60918-471-1
• Abramowitz, J. S. & Jacoby, R. J. (2015). Obsessive-compulsive disorder in adults: Advances in Psychotherapy—Evidence-based practice. Boston: Hogrefe Publishing. ISBN 978-0-88937-411-9
• Abramowitz, J. S., McKay, D., & Storch, E. A. (Eds.) (2017). The Wiley handbook of obsessive-compulsive disorders. Hoboken, NJ: Wiley. ISBN 9781118889640
• Abramowitz, J. S. (2018). Getting over OCD: A 10-step workbook for taking back your life (2nd edition). New York: Guilford Press. ISBN 9781593859992
• Abramowitz, J. S., Deacon, B. J., & Whiteside, S. P. (2019). Exposure therapy for anxiety: Principles and practice (2nd ed). New York: Guilford Press. ISBN 9781462539529
• Abramowitz, J. S., & Blakey, S. M. (2020). Clinical handbook of fear and anxiety: Maintenance processes and treatment mechanisms. Washington DC: American Psychological Association. ISBN 978-1-4338-3065-5

Journal articles

• Abramowitz, J.S. (1996). "Variants of exposure and response prevention in the treatment of obsessive-compulsive disorder: A meta-analysis". Behavior Therapy. 27 (4): 583–600. doi:10.1016/S0005-7894(96)80045-1.
• Abramowitz, J.S. (1997). "Effectiveness of psychological and pharmacological treatments for obsessive-compulsive disorder: A quantitative review of the controlled treatment literature". Journal of Consulting and Clinical Psychology. 65 (1): 44–52. doi:10.1037/0022-006X.65.1.44. PMID 9103733. S2CID 20859800.
• Franklin, M.E.; Abramowitz, J.S.; Kozak, M.J.; Levine, J.; Foa, E.B. (2000). "Effectiveness of exposure and ritual prevention for obsessive-compulsive disorder: A comparison of randomized and clinic patients". Journal of Consulting and Clinical Psychology. 68 (4): 594–602. CiteSeerX 10.1.1.583.4406. doi:10.1037/0022-006X.68.4.594. PMID 10965635.
• Abramowitz, J.S.; Tolin, D.F.; Street, G.P. (2001). "Paradoxical effects of thought suppression: A meta-analysis of controlled studies". Clinical Psychology Review. 21 (5): 683–703. doi:10.1016/S0272-7358(00)00057-X. PMID 11434226.
• Abramowitz, J. S.; Franklin, M. E.; Schwartz, S. A.; Furr, J. M. (2003). "Symptom presentation and outcome of cognitive-behavior therapy for obsessive-compulsive disorder". Journal of Consulting and Clinical Psychology. 71 (6): 1049–1057. doi:10.1037/0022-006X.71.6.1049. PMID 14622080. S2CID 10615562.
• Abramowitz, J. S.; Foa, E. B.; Franklin, M. E. (2003). "Exposure and ritual prevention for obsessive-compulsive disorder: Effectiveness of intensive versus twice-weekly treatment sessions". Journal of Consulting and Clinical Psychology. 71 (2): 394–398. doi:10.1037/0022-006X.71.2.394. PMID 12699033. S2CID 11121137.
• Whiteside, S. P.; Port, J. D.; Abramowitz, J. S. (2004). "A meta-analysis of functional neuroimaging in obsessive-compulsive disorder". Psychiatry Research: Neuroimaging. 132 (1): 69–79. doi:10.1016/j.pscychresns.2004.07.001. PMID 15546704. S2CID 9941792.
• Abramowitz, J. S.; Whiteside, S. P.; Deacon, B. J. (2005). "The effectiveness of treatment for pediatric obsessive-compulsive disorder: A meta-analysis". Behavior Therapy. 36: 55–63. doi:10.1016/S0005-7894(05)80054-1.
• Taylor, S.; Zvolensky, M.; Cox, B.; Deacon, B.; Heimberg, R.; Ledley, D. R.; Abramowitz, J. S.; Holoway, R.; Sandin, B.; Stewart, S.; Coles, M.; Eng, W.; Daly, E.; Arrindell, W.; Bouvard, M.; Cardenas, S. (2007). "Robust dimensions of anxiety sensitivity: Development and initial validation of the anxiety sensitivity index-3 (ASI-3)". Psychological Assessment. 19 (2): 176–188. doi:10.1037/1040-3590.19.2.176. PMID 17563199. S2CID 456886.
• Fairbrother, N; Abramowitz, JS (2007). "New parenthood as a risk factor for the development of obsessional problems". Behav Res Ther. 45 (9): 2155–63. doi:10.1016/j.brat.2006.09.019. PMID 17084810.
• Abramowitz, J. S.; Taylor, S.; McKay, D. (2009). "Obsessive-compulsive disorder". The Lancet. 374 (9688): 491–499. doi:10.1016/S0140-6736(09)60240-3. PMID 19665647. S2CID 203833429.
• Abramowitz, J. S.; Deacon, B.; Olatunji, B.; Wheaton, M. G.; Berman, N.; Losardo, D.; Timpano, K.; McGrath, P.; Riemann, B.; Adams, T.; Bjorgvinsson, T.; Storch, E.; Hale, L. (2010). "Assessment of obsessive-compulsive symptom dimensions: Development and evaluation of the Dimensional Obsessive-Compulsive Scale". Psychological Assessment. 22 (1): 180–198. doi:10.1037/a0018260. PMID 20230164. S2CID 7206349.
• Berman, N. C.; Wheaton, M. G.; Abramowitz, J. S. (2012). "The Arnold Schwarzenegger Effect: Is strength of the "victim" related to misinterpretations of harm intrusions?". Behaviour Research and Therapy. 50 (12): 761–766. doi:10.1016/j.brat.2012.09.002. PMID 23085185.
• Abramowitz, J. S.; Baucom, D. H.; Boeding, S.; Wheaton, M. G.; Pukay-Martin, N.; Fabricant, L. E.; Paprocki, C.; Fischer, M. (2013). "Treating obsessive-compulsive disorder in intimate relationships: A pilot study of couple-based cognitive-behavior therapy". Behavior Therapy. 44 (3): 395–407. doi:10.1016/j.beth.2013.02.005. PMID 23768667.
• Fabricant, L. E.; Abramowitz, J. S.; Dehlin, J. P.; Twohig, M. P. (2013). "A comparison of two brief interventions for obsessional thoughts: Exposure and acceptance". Journal of Cognitive Psychotherapy. 27 (3): 195–209. doi:10.1891/0889-8391.27.3.195. PMID 32759141. S2CID 9643633.
• Abramovitch, A.; Abramowitz, J. S.; Mittleman, A. (2013). "The neuropsychology of adult obsessive-compulsive disorder: A meta-analysis". Clinical Psychology Review. 33 (8): 1163–1171. doi:10.1016/j.cpr.2013.09.004. PMID 24128603.
• Abramowitz, J. S.; Fabricant, L. E.; Taylor, S.; Deacon, B. J.; McKay, D.; Storch, E. A. (2014). "The relevance of analogue studies for understanding obsessions and compulsions". Clinical Psychology Review. 34 (3): 206–217. doi:10.1016/j.cpr.2014.01.004. PMID 24561743.
• Abramowitz, J. S.; Jacoby, R. J. (2014). "Scrupulosity: A cognitive-behavioral analysis and implications for treatment". Journal of Obsessive-Compulsive and Related Disorders. 3 (2): 140–149. doi:10.1016/j.jocrd.2013.12.007.
• Abramowitz, JS; Jacoby, RJ (2015). "Obsessive-compulsive and related disorders: a critical review of the new diagnostic class". Annu Rev Clin Psychol. 11: 165–86. doi:10.1146/annurev-clinpsy-032813-153713. PMID 25581239. S2CID 45823266.
• Jacoby, R. J.; Abramowitz, J. S. (2016). "Inhibitory Learning Approaches to Exposure Therapy: A Critical Review and Translation to Obsessive-Compulsive Disorder". Clinical Psychology Review. 49: 28–40. doi:10.1016/j.cpr.2016.07.001. PMID 27521505.
• Blakey, S. M.; Abramowitz, J. S. (2016). "The effects of safety behaviors during exposure therapy for anxiety: Critical analysis from an inhibitory learning perspective.". Clinical Psychology Review. 49: 1–15. doi:10.1016/j.cpr.2016.07.002. PMID 27475477.
• Blakey, S. M.; Abramowitz, J. S.; Reuman, L.; Leonard, R. C.; Riemann, B. C. (2017). "Anxiety sensitivity as a predictor of outcome in the treatment of obsessive-compulsive disorder". Journal of Behavior Therapy and Experimental Psychiatry. 57: 113–117. doi:10.1016/j.jbtep.2017.05.003. PMID 28505489.
• Twohig, M.; Abramowitz, J. S.; Smith, B. M.; Fabricant, L. E.; Jacoby, R. J.; Morrison, K. L.; Bluett, E. J.; Reuman, L.; Blakey, S. M.; Lederman, T. (2018). "Adding acceptance and commitment therapy to exposure and response prevention for obsessive-compulsive disorder: A randomized controlled trial". Behaviour Research and Therapy. 108: 1–9. doi:10.1016/j.brat.2018.06.005. PMID 29966992.
• Jacoby, R. J.; Abramowitz, J. S.; Blakey, S. M.; Reuman, L. (2019). "Is the hierarchy necessary? A randomized clinical trial of gradual versus variable exposure intensity in the treatment of unacceptable obsessional thoughts". Journal of Behavior Therapy and Experimental Psychiatry. 64: 54–63. doi:10.1016/j.jbtep.2019.02.008. PMID 30851653.
• Buchholz, J. L.; Abramowitz, J. S. (2020). "The Therapeutic Alliance in Exposure Therapy for Anxiety-Related Disorders: A Critical Review". Journal of Anxiety Disorders. 70: 102194. doi:10.1016/j.janxdis.2020.102194. PMID 32007734.